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Saw palmetto for BPH: Does it work?

Benign prostate hyperplasia (BPH) is a common condition in older people. The prostate grows bigger and impedes the flow of urine. It causes urinary tract and bladder symptoms that gradually get worse over time.

Saw palmetto, or Serenoa repens, is a plant that people use as a natural remedy. Native Americans used to take the herb to enhance fertility and treat urinary tract issues. According to The New England Journal of Medicine, over 2 million men in the United States use the herb to treat BPH and other prostate issues. However, there is limited research to support its efficacy.

Read on to learn more about taking saw palmetto for BPH.

Does saw palmetto work for BPH?

Saw palmetto seems to slow down the production of a particular enzyme called 5-alpha reductase, this enzyme converts testosterone into dihydrotestosterone (DHT) in the prostate gland.

Although DHT plays a vital role in the development of the prostate, it can also lead to prostate issues such as BPH.

Many people believe that taking saw palmetto will reduce their BPH symptoms by blocking DHT production.

However, there is a lack of evidence to confirm that saw palmetto benefits prostate health.

What the research says

Although some early research suggested that saw palmetto could benefit people with BPH symptoms, later studies contradicted these findings.

A study published in 2011 followed the progress of 306 men with moderate BPH symptoms over 72 weeks as they took either saw palmetto fruit extracts or a placebo. The results showed that there was no significant difference in the results between the two groups.

Even when the participants took a triple dose of saw palmetto instead of the standard dose of 320 milligrams (mg) common in earlier research, the participants experienced no significant benefits.

These findings support 2006 research, which found no improvement in BPH symptoms after 12 months of saw palmetto use.

A 2012 Cochrane review of 32 randomized controlled trials involving 5,666 men further disputes the efficacy of saw palmetto in treating symptoms of BPH. The review states that saw palmetto does not improve excessive night-time urination (nocturia), peak urine flow, or other urinary symptoms when compared with a placebo.

Saw palmetto for other conditions

People often use saw palmetto to treat other health conditions, such as:

  • hair loss
  • hormone problems
  • low sex drive
  • pelvic pain
  • prostate cancer
  • low sperm count
  • urinary problems

The National Center for Complementary and Integrative Health (NCCIH) state that there is no scientific evidence to suggest that saw palmetto is effective for any health condition, despite its popularity as an herbal remedy.

There are more effective treatments for these problems. It is always best to speak to a doctor before taking any herbal medication or supplement.

Saw palmetto causes relatively few side effects. It may occasionally lead to mild symptoms such as digestive upset, bad breath, or headaches.

Even when people take high doses of up to 960 mg, studies show that saw palmetto does not typically trigger severe reactions.

However, there are rare cases of people associating saw palmetto with their liver problems so anyone who has or had liver disease should avoid taking it.

The herb is also unlikely to interact with medications, but there are no studies to prove it is safe. Therefore, individuals who are taking any other medications and wish to try saw palmetto should check with their doctor first. There is some risk of saw palmetto interacting with aspirin or blood-clotting drugs.

Finally, studies to date have focused on males using saw palmetto. There is not much information available on the effects or safety of the herb in females or children.

Medical treatments for BPH

People with BPH may wish to try medical treatments, especially when their symptoms are severe or natural remedies do not work.

Factors that will affect the choice of medical treatment include the person’s age, the size of their prostate, and the severity of their symptoms.

Treatment options include:


Several medications are available to treat BPH when symptoms are mild or moderate, including:

  • 5-alpha reductase inhibitors, such as dutasteride (Avodart) and finasteride (Proscar). These medications slow down DHT production.
  • Alpha-blockers, such as alfuzosin (Uroxatral), doxazosin (Cardura), and tamsulosin (Flomax). These drugs relax muscles in the prostate and bladder to make urination easier.

Sometimes, a doctor may recommend taking a combination of 5-alpha reductase inhibitors and alpha-blockers.

Lifestyle changes and home remedies can alleviate the symptoms of an enlarged prostate. People with BPH can try:

  • Training the bladder to urinate at regular intervals (typically every 4 hours).
  • Avoiding waiting too long to urinate as this can damage the bladder muscle.
  • Waiting a few moments after urinating and then trying to urinate again. This technique, called double voiding, helps to ensure the bladder is completely empty.
  • Eating a healthful diet and maintaining a normal body weight.
  • Exercising regularly to avoid urine retention.
  • Keeping warm to avoid urine retention and reduce urinary urgency.
  • Stopping the consumption of fluids 2 hours before bed to prevent nocturia.
  • Avoiding caffeine and alcohol as they both irritate the bladder.
  • Limiting the use of decongestants and antihistamines as these medications reduce urine flow.

When to see a doctor

Individuals who notice changes in their urinary habits should see a doctor, even if the symptoms do not cause discomfort. Any changes can suggest an underlying medical condition that may require prompt treatment. It is best to talk to a doctor before taking any herb or medication.

Untreated urinary issues can lead to complications such as an obstruction in the urinary tract, which prevents urination. People who cannot pass any urine need emergency medical treatment.


Most people will see an improvement in BPH symptoms following treatment. To prevent symptoms from returning or worsening, a doctor may recommend taking medication on a long-term basis. Sometimes, repeat treatments may be necessary to control symptoms.

Many men will also feel better when they make lifestyle changes, such as eating healthily, exercising, and training the bladder.

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